title: Has Medicare Part D reduced racial/ethnic disparities in prescription drug use and spending?
abstract: OBJECTIVE
  To evaluate whether Medicare Part D has reduced racial/ethnic disparities in prescription drug utilization and spending.
  
  
  METHODS
  Nationally representative data on white, African American, and Hispanic Medicare seniors from the 2002-2009 Medical Expenditure Panel Survey are analyzed. Five measures are examined: filling any prescriptions during the year, the number of prescriptions filled, total annual prescription spending, annual out-of-pocket prescription spending, and average copay level.
  
  
  METHODS
  We apply the Institute of Medicine's definition of a racial/ethnic disparity and adopt a difference-in-difference-in-differences (DDD) estimator using a multivariate regression framework. The treatment group consists of Medicare seniors, the comparison group, adults without Medicare aged 55-63 years.
  
  
  RESULTS
  Difference-in-difference-in-differences estimates suggest that for African Americans Part D increased the disparity in annual spending on prescription drugs by $258 (p=.011), yet had no effect on other measures of prescription drug disparities. For Hispanics, DDD estimates suggest that the program reduced the disparities in annual number of prescriptions filled, annual total and out-of-pocket spending on prescription drugs by 2.9 (p=.077), $282 (p=.019) and $143 (p<.001), respectively.
  
  
  CONCLUSIONS
  Medicare Part D had mixed effects. Although it reduced Hispanic/white disparities related to prescription drugs among seniors, it increased the African American/white disparity in total annual spending on prescription drugs.
authors.affiliation: Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI.
authors.forename: Elham
authors.initials: E
authors.lastname: Mahmoudi
authors.forename: Gail A
authors.initials: GA
authors.lastname: Jensen
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005382:Financing, Personal / Q000191:economics / Q000706:statistics & numerical data; D006304:Health Status; D054625:Healthcare Disparities / Q000191:economics* / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D054524:Medicare Part D / Q000706:statistics & numerical data*; D008875:Middle Aged; D055553:Prescription Drugs / Q000191:economics*; D044469:Racial Groups / Q000706:statistics & numerical data*; D012737:Sex Factors; D014481:United States; D044465:White People
chemical_list: D055553:Prescription Drugs
keywords: Medicare Part D; prescription drugs; racial/ethnic disparities; utilization and spending